Distinct phenotypes within autosomal recessive ataxias not linked to already known loci
Author: Bouhlal Y, El Euch Fayeche G, Amouri R, Hentati F.
Source:
Acta myologica: myopathies and cardiomyopathies: official journal of the Mediterranean Society of Myology, 24(2), 155-161.
Autosomal recessive ataxias represent a large group of neurodegenerative
disorders characterized by progressive degeneration of central and peripheral
nervous systems and a genetic heterogeneity. To analyse clinical,
neurophysiological and nerve biopsy findings in 14 Tunisian unrelated families
showing linkage exclusion to the known autosomal recessive ataxia loci, 20
Tunisian families with a total of 73 affected subjects were selected on the
presence of a clinical phenotype associating a cerebellar ataxia with retained
tendon reflexes on at least the index patient. A genetic linkage study was
performed with markers spanning the Friedreich ataxia, Spastic ataxia of the
Charlevoix-Saguenay, Autosomal recessive ataxia associated with isolated vitamin
E deficiency, Ataxia with oculomotor apraxia, Infantile onset spinocerebellar
ataxia, Ataxia with Hearing Loss and Optic Atrophy, AT, ATLD, Spinocerebellar
ataxia with axonal neuropathy, Cayman ataxia, Cerebellar ataxia with mental
retardation optic atrophy and skin abnormalities, Salla syndrome,
Marinesco-Sjögren and the Childhood Spinocerebellar Ataxia loci. Out of the 20
families, 4 showed linkage to the spastic ataxia of the Charlevoix-Saguenay
locus, one to the Friedreich ataxia locus and one to the Ataxia with oculomotor
apraxia locus. Linkage to all tested loci has been excluded in the 14 remaining
families. These families were divided into 3 groups according to tendon reflex
status in lower limbs which appear as the most obvious distinguishing clinical
sign between patients and families: Group A was characterized by brisk tendon
reflexes in lower limbs, group B by a homogeneous feature of tendon reflexes with
the absence of ankle reflexes and brisk knee reflexes and group C by variable
features of tendon reflexes in lower limbs within the same family. Haplotype
analysis and Lod score calculation did not show any evidence of linkage to the 16
known loci of cerebellar ataxias. Aim of this study was to reveal the vast
clinical phenotypic variability in patients with autosomal recessive ataxia not
linked to known loci. Data obtained indicate that detailed clinical and
neurophysiological nerve investigations will be essential in order to pool
patients within homogeneous subgroups for gene mapping.